中国非ST段抬高型心肌梗死患者住院期间死亡的危险因素分析
发布时间：2018-11-18 10:18
【摘要】：目的:探讨中国非ST段抬高型心肌梗死患者(NSTEMI)住院期间死亡的危险因素。方法:纳入2013-01至2014-09期间参加中国急性心肌梗死(CAMI)注册登记研究的NSTEMI患者5 816例。352例患者在住院期间死亡,为住院期死亡组,余住院期间生存的5 464例患者为住院期生存组。收集患者基线资料、实验室检查、治疗方法、院内结局等资料,以住院期间死亡为主要结局指标构建多因素Logistic回归模型,探讨NSTEMI患者住院期间死亡独立危险因素。结果:6.05%(352/5816)的NSTEMI患者在住院期间死亡,两组患者基线资料存在显著差异。多因素Logistic回归分析结果提示,年龄[每增加1岁,比值比(OR)=1.027;95%可信区间(CI):1.014~1.041;P0.01)、体重指数(每增加1kg/m~2,OR=0.943;95%CI:0.900~0.988;P0.01)、收缩压(每增加1 mmH g,OR=0.983;95%CI:0.978~0.988;P0.01)、Killip心功能分级(每增加1级,OR=1.565;95%CI:1.370~1.786;P0.01)、心跳骤停(OR=3.118;95%CI:1.339~7.262;P0.01)、ST段压低(OR=1.571;95%CI:1.169~2.110;P0.01)、新发完全性左束支传导阻滞(OR=4.579;95%CI:1.876~11.177;P0.01)、血肌酐(每增加1μmol/L,OR=1.004;95%CI:1.002~1.005;P0.01)、白细胞计数(每增加1×109/L,OR=1.100;95%CI:1.071~1.130;P0.01)、从不吸烟(OR=2.080;95%CI:1.460~2.962;P0.01)、既往心肌梗死病史(OR=1.913;95%CI:1.298~2.820;P0.01)、经皮冠状动脉介入治疗(PCI)史(OR=0.322;95%CI:0.142~0.729;P0.01)是患者住院期间死亡的独立危险因素。结论:本研究发现12个因素是NSTEMI患者住院期间死亡的独立危险因素,有助于临床医生早期识别高危患者并选择最佳诊疗策略。
[Abstract]:Objective: to investigate the risk factors of (NSTEMI) death in patients with non-ST segment elevation myocardial infarction in China. Methods: a total of 5,816 NSTEMI patients were enrolled in the (CAMI) registration study between January 2013 and September 2014 in China. 352 patients died during hospitalization. The remaining 5 464 patients who survived during hospitalization were in the hospitalization survival group. The data of baseline data, laboratory examination, treatment method and in-hospital outcome were collected, and the multivariate Logistic regression model was constructed to explore the independent risk factors of death during hospitalization of NSTEMI patients. Results: 6.05% (352 / 5816) of NSTEMI patients died during hospitalization, and there was significant difference in baseline data between the two groups. The results of multivariate Logistic regression analysis showed that age [1 year old, (OR) = 1.027 95% confidence interval (CI): 1.014 + 1.041% P0.01], body mass index (1 kg / m ~ (2) and body mass index (0. 943); 95 CI: 0.900 0. 988 P0.01), systolic blood pressure (0. 983% CI 0. 983% CI 0. 978 0. 988 P0.01), systolic blood pressure (1), Killip per increase, OR=1.565;95%CI:1.370~1.786;). P0.01), cardiac arrest (OR=3.118;95%CI:1.339~7.262;P0.01), ST segment depression (OR=1.571;95%CI:1.169~2.110;P0.01), new complete left bundle branch block (OR=4.579;) The blood creatinine (1 渭 mol/L,OR=1.004;95%CI:1.002~1.005;P0.01 increase), the white blood cell count (1 脳 10 9 / L) and the CI: 1.071% 1.100% 1.100% CI: 1.100% P0.01), and the blood creatinine (1 渭 mol/L,OR=1.004;95%CI:1.002~1.005;P0.01), the white blood cell count (1.100%, 1.100%, 1.130% per 1 脳 10 9 / L). P0.01), never smoking (OR=2.080;95%CI:1.460~2.962;P0.01), previous history of myocardial infarction (OR=1.913;95%CI:1.298~2.820;P0.01), (PCI) history of percutaneous coronary intervention (OR=0.322;) 95 CI: 0. 142, 0. 729, P0.01) is an independent risk factor for death in hospital. Conclusion: this study found that 12 factors were independent risk factors for the death of NSTEMI patients during hospitalization, which was helpful for clinicians to identify high-risk patients early and select the best diagnosis and treatment strategy.
【作者单位】： 中国医学科学院北京协和医学院国家心血管病中心阜外医院冠心病诊治中心;中国医学科学院北京协和医学院心血管疾病国家重点实验室;山西省长治市人民医院心血管内科;安徽省阜阳市人民医院心血管内科;湖北省天门市第一人民医院心血管内科;
【基金】：国家“十二·五”科技支撑计划课题(2011BAI11B02) 公益性行业科研专项项目(201402001)
【分类号】：R542.22
[Abstract]:Objective: to investigate the risk factors of (NSTEMI) death in patients with non-ST segment elevation myocardial infarction in China. Methods: a total of 5,816 NSTEMI patients were enrolled in the (CAMI) registration study between January 2013 and September 2014 in China. 352 patients died during hospitalization. The remaining 5 464 patients who survived during hospitalization were in the hospitalization survival group. The data of baseline data, laboratory examination, treatment method and in-hospital outcome were collected, and the multivariate Logistic regression model was constructed to explore the independent risk factors of death during hospitalization of NSTEMI patients. Results: 6.05% (352 / 5816) of NSTEMI patients died during hospitalization, and there was significant difference in baseline data between the two groups. The results of multivariate Logistic regression analysis showed that age [1 year old, (OR) = 1.027 95% confidence interval (CI): 1.014 + 1.041% P0.01], body mass index (1 kg / m ~ (2) and body mass index (0. 943); 95 CI: 0.900 0. 988 P0.01), systolic blood pressure (0. 983% CI 0. 983% CI 0. 978 0. 988 P0.01), systolic blood pressure (1), Killip per increase, OR=1.565;95%CI:1.370~1.786;). P0.01), cardiac arrest (OR=3.118;95%CI:1.339~7.262;P0.01), ST segment depression (OR=1.571;95%CI:1.169~2.110;P0.01), new complete left bundle branch block (OR=4.579;) The blood creatinine (1 渭 mol/L,OR=1.004;95%CI:1.002~1.005;P0.01 increase), the white blood cell count (1 脳 10 9 / L) and the CI: 1.071% 1.100% 1.100% CI: 1.100% P0.01), and the blood creatinine (1 渭 mol/L,OR=1.004;95%CI:1.002~1.005;P0.01), the white blood cell count (1.100%, 1.100%, 1.130% per 1 脳 10 9 / L). P0.01), never smoking (OR=2.080;95%CI:1.460~2.962;P0.01), previous history of myocardial infarction (OR=1.913;95%CI:1.298~2.820;P0.01), (PCI) history of percutaneous coronary intervention (OR=0.322;) 95 CI: 0. 142, 0. 729, P0.01) is an independent risk factor for death in hospital. Conclusion: this study found that 12 factors were independent risk factors for the death of NSTEMI patients during hospitalization, which was helpful for clinicians to identify high-risk patients early and select the best diagnosis and treatment strategy.
【作者单位】： 中国医学科学院北京协和医学院国家心血管病中心阜外医院冠心病诊治中心;中国医学科学院北京协和医学院心血管疾病国家重点实验室;山西省长治市人民医院心血管内科;安徽省阜阳市人民医院心血管内科;湖北省天门市第一人民医院心血管内科;
【基金】：国家“十二·五”科技支撑计划课题(2011BAI11B02) 公益性行业科研专项项目(201402001)
【分类号】：R542.22
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